Individual provider Active NPI

Dhruv J Shah, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Fairlawn, OH
National Provider Identifier
1881670628
Registry record updated Apr 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
35084026S Issued in OH
Practice address
3610 W Market St
Suite 108
Fairlawn, OH 44333-9301
Phone
(330) 666-1400
Fax
(330) 666-0500
NPI assigned
Dec 22, 2005
Last updated
Apr 26, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 35084026S OH Primary

Addresses

Primary practice location

3610 W Market St
Suite 108
Fairlawn, OH 44333-9301

Mailing address

3610 W Market St
Suite 108
Fairlawn, OH 44333-9301
Phone (330) 666-1400

Other identifiers 1

IdentifierTypeStateIssuer
2589220MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050728000001 OH Practitioner - Pain ManagementPractitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 7113990797 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

57 Baker Blvd
Fairlawn, OH 44333-3601
Phone (330) 666-1400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.52 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
81.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35084026SOHMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Action Spine and Pain Center, PC Pain Medicine CurrentSince Jun 1, 2005 Accepting new patients
Community Orthopedics, Dr. Dhiman and Associates Past Accepting new patients
Syracuse Orthopedic Specialists, PLLC Past Accepting new patients

Locations

3610 W Market St
Ste 108
Fairlawn, OH 44333
Phone (330) 666-1400

57 Baker Blvd
Fairlawn, OH 44333
Phone (330) 666-1400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366934400000",
    "number": "1881670628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 W MARKET ST",
            "address_2": "SUITE 108",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339301",
            "telephone_number": "330-666-1400",
            "fax_number": "330-666-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 W MARKET ST",
            "address_2": "SUITE 108",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443339301",
            "telephone_number": "330-666-1400",
            "fax_number": "330-666-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DHRUV",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2013-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "OH",
            "license": "35084026S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2589220",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

Verify at the official NPI Registry.